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Home My WebLink About2562 STATE ST; ; 81-59; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license Is In full force and ef- fect. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con· tractor's License Law for the following reason (Sec. 7031.5,Buslness and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to file a signed state- ment that he Is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that Is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or of- fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or of• fered for sale. If, however, the building or improve- ment Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). '.JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business 2.nd Professions Code: The Contractor's License Law does not ap- ply to an owner of property \•ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec, _____ 8. & P.C. for this reason, ____________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, o• a certificate of Worlt,,rs' Compensation Insurance, or a certified ct,g thereof (Sec. 3800, Labor Code). POLICY NO ~L COMPANY I □Copy Is filed with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($11JO) or less). I certify that In the performance of the work for which this permit ls Issued, I shall not employ any person fn any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer- tificate of Exemption, you should become subject to the Wo"lkers· Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ding agency for the performance of the work for which this permit Is Issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (7 14) 438-5525 I I N0~&0.~ I I 51 _A J nJOB Asf 1<. l 11 'f r f'-t I I I I I I I I I I I I I APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. tR~T. IDAl-~RL8TN ,x~7 PERMIT NUMBER 91" OWNJ:;-f1Yt/K./2JT + ~ <:;.;..~ f 1dw OWNER'S PHONE --/d9·h"3 P74-;N?CTk~✓ ~8Lljf3s/ ·s-;Qfln .L~ :CC I ,..,..., I"'. ' o~•s iA~G AOORE:S:Lvi J n Jf-~'vvm CONT~ACTOq ADDR'r j_/'I J h m~ifj R ·-• u,..,..,~.., y I 9".~ 5 I> rry -~/ t ./Y r;rr{ LOT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. DESIGNER •sT ATE LICENSE I I I I I I I I I I I DESCR'7~~r;;J ,,{ ../..n,lol-I.M1/ ~ DESIGNER'S ADDRESS DESIGNER'S PHONE ' FL/nfY' ~4-1w CENSUS TRACT GP L.t.NO USE ZONING I RES. UNITS I PARKING SPACE I NUMBER OF STORIES Not V1fid Unless Machin, c.rtifi-1 BLOG SQ. FT, BLOG USE OCC. GP ST AN DARO PLAN II I PLAN ID II I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY . MECHANICAL PERMIT AMT. .. <. EACH FIXTURE TRAP (t,,. (?)I INSTALL FURN. DUCTS UP TD 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER AND/DR VENT BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP , . EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT ___., EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS ..,,/ VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/HEATER__........... BUILDING PERMIT I . I I I Issue 3.00 Issue ~ 3.00 SIGN PERMIT I I I I I TOTAL PLUMBING TOTAL~ PLAN CHECK I I I I C,.orJ . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT A~l f ~ILE HOME PERMIT AMT. TOTAL PLUMBING I 1QA--P QTY. QTY. ELECTRICAL ' t( I NEW CONST EA AMP/SWT /BKR J r ~ I/AWNING MECHANICAL I I I t PH .25 3 PH f I ~v PORCH MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR / ~7 SET-UP SOLAR I I I I 1 PH .25 _.,3PH I' 1.// RAMAD CABQrlf'A I I I I I REMODEL/ALTER PER CIRCUIT v _/ ./.,. FENCE 1/-'4(' 6' STRONG MJTION. I . I I I TEMP POLE 200 AMPS / V ('/\ TOTAU WkLE HOME MICO -FILM I I I I OVER 200 AMPS V 0-~ ., I I I I ~ -; TEMP OCCUPANCY (30 OAYSV "-.J A ~,,,. ... / I (Y I . I I I T ~c-,,a / t~ 2.00 I 1tl I . I I I TOTALELE~ v\/ I J TOTAL FEES PAYABLE I I lq!!f,-CONTRACTOR I I I . SCHOOL FEES: ' I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT, AND 0~ -~. ,o, m,,.,,o•s om J)~1r1 HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I ,..-·oma•o o,mo ~ FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTU VER 3 STO ES IN HEIGHT COUNTY ANO STATE LAWS GOVERNINCfBUILOING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM" LESS THE CITY OF CAR LS BAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND _..--z.., ~ ... EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. tf"(-1c~s1<!NATURE· OWNERQ CONTRACT:?□=~ // DATE . AGENT D BY PHONE □ 'L;:f;,I. ID-Fl I tp ! < 0 ~ > ~ j::: hl c.. V, ~ SITE . I ADDRESS: OWNER: PERMIT NO: -, . -FIELD INSPECTION RECORD . INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR - FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING -~ ~ UNDER FLOOR HEATING " -, J. ,':'" ' . OK TO INSTALL SUB FLOOR < . ... ~ .f I ' -. , t ,. . ... SLAB FLOOR UNDER SLAB PLUMBING FOOTING• FORMS• SETBACK • TOILET OK TO POUR CONCRETE - FRAME . ROUGH ELECTRICAL . ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO FIREPLACE . DAMPER & STEEL PLATE TIES/HEIGHT OF CHIMNEY . ' " ' .. :, . OTHER TEMP POWER (POLE) I SEWER : ' GAS TEST ' SWIM POOL • STEEL BONDING .. • PRE DECK ' .. • FENCE PREPLASTER I SHOWN • FRAME -• PAN -r• . FINAL INSP BY BLDG DEPT - OTHER DEPT'S REQ COMPLETED . / . ELEC METER-PERM-TEMP ., GAS METER-PERM-TEMP " CERT OF OCCUPANCY ISSUED -